Linking depressive symptoms and cognitive functioning: The mediating role of leisure activity

Moderating role of depression in the association between leisure activity and cognitive function among the disabled older people

Background

This study delves into the complex interaction between leisure activities and cognitive function in older people with disabilities, with a particular emphasis on the moderating influence of depression. Despite the well-documented cognitive benefits of leisure activities among the older people, the intricate relationship between depression and the association between leisure activities and cognitive function in this specific demographic has been rarely reported.

Methods

Drawing on data from the 2017-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study meticulously examined a cohort of 713 participants aged 65-89 years. We constructed a moderation model to examine the impact of leisure activity on cognitive function in older people with disabilities, with depression levels as a moderating variable.

Results

We found a positive association between engagement in leisure activities and cognitive function, highlighting the potential cognitive advantages associated with leisure engagement among disabled older people. However, the present analysis also reveals a significant moderation effect of depression on this relationship, shedding light on the nuanced nature of this association. Specifically, elevated levels of depression emerge as a critical moderator, attenuating the otherwise favorable impact of leisure activities on cognitive function among older people contending with disabilities.

Conclusion

In conclusion, the findings provide a compelling rationale for tailored interventions that comprehensively target both leisure activity engagement and concurrent depression management, effectively fostering improvements in cognitive function among the cohort of disabled older people.

The longitudinal relationship between leisure activities and depressive symptoms among older Chinese adults: an autoregressive cross-lagged analysis approach

BACKGROUND

Existing studies have shown a correlation between leisure activities and depressive symptoms in older adults, but the direction of the longitudinal relationship is inconsistent. This study used an autoregressive cross-lagged model to examine the longitudinal relationship between leisure activity participation and geriatric depression.

METHODS

A total of 7,138 participants aged 60 years or older from the 2nd to the 4th wave of the China Health and Retirement Longitudinal Study (CHARLS) were analysed.

RESULTS

First, present depressive symptoms were significantly associated with future depressive symptoms (β2013-2015 = .893, p < .001; β2015-2018 = .946, p < .001), and the same rule applied to leisure activities (β2013-2015 = .402, p < .001; β2015-2018 = .404, p < .001). Second, current depressive symptoms negatively predicted future leisure activities (β2013-2015 = -.071, p < .001; β2015-2018 = -.085, p < .001), but the inverse relationship was not statistically significant (β2013-2015 = -.003, p > .05; β2015-2018 = -.003, p > .05).

CONCLUSION

These findings underscore the importance of interventions targeting depressive symptoms to potentially enhance engagement in leisure activities among older adults. The results contribute to the understanding of the complex dynamics between mental health and lifestyle choices in older populations, highlighting the potential of proactive mental health interventions to improve overall well-being.

Leisure activity engagement across adulthood predicts cognitive change after five years: Do gender and age matter?

OBJECTIVE

To examine the association between leisure activity (LA) frequency and cognitive trajectories over 5 years across adulthood, and whether gender and age moderate these associations.

METHOD

A total of 234 cognitively healthy adults (21-80 years) completed a LA questionnaire at baseline and neuropsychological measures at baseline and after 5 years. Latent change score analysis was applied to generate latent variables estimating changes in different cognitive domains. For a secondary analysis, LA components' scores were calculated, reflecting cognitive-intellectual, social, and physical activities. Regression analysis examined the association between baseline LA and cognitive change, and potential moderation of gender and age. In addition, we tested the influence of cortical gray matter thickness on the results.

RESULTS

We found that higher LA engagement was associated with slower cognitive decline for reasoning, speed, and memory, as well as better vocabulary across two time points. Regarding LA components, higher Social-LA and Intellectual-LA predicted slower rates of cognitive decline across different domains, while Physical-LA was not associated with cognitive change. Gender, but not age, moderated some of the associations observed. Our results remained the same after controlling for cortical gray matter thickness.

CONCLUSIONS

We demonstrated a protective effect of LA engagement on cognitive trajectories over 5 years, independent from demographics and a measure of brain health. The effects were in part moderated by gender, but not age. Results should be replicated in larger and more diverse samples. Our findings support cognitive reserve hypothesis and have implications for future reserve-enhancing interventions.

The mediating effect of leisure activities in the relationship between depression and cognitive decline in middle age and older adults in Taiwan

BACKGROUND

Depression can affect the development of cognitive functions, and there are many people with depressive symptoms and cognitive decline in the aging population. The role of mediators between depressive symptoms and the subsequent cognitive decline remains unclear. We aimed to investigate whether depressive symptoms can slow down cognitive decline through a mediator.

METHODS

A total of 3,135 samples were collected in 2003, 2007, and 2011. This study used the CES-D10 and SPMSQ (Short Portable Mental State Questionnaire) to measure depression and cognitive functions. The effect of depression trajectory on the subsequent cognitive dysfunction was analyzed using multivariable logistic regression, and the mediating effect was analyzed using the Sobel test.

RESULTS

The results of the multivariable linear regression analysis showed that after including different variables in each model, such as leisure activities and mobility in 2003 and 2007, women had a higher percentage of depressive symptoms in each model, compared to men. The effect of depression in 2003 on cognitive decline in 2011 was mediated by intellectual leisure activities in 2007 in men (Z=-2.01) and physical activity limitation in 2007 in women (Z=-3.02).

CONCLUSIONS

The mediation effect of this study shows that people with depressive symptoms will reduce their participation in leisure activities, which will lead to the degeneration of cognitive function. We suggest that if depressive symptoms are addressed as early as possible, people will have the ability and motivation to delay the decline of cognitive function through participation in leisure activities.

Moderating Role of Cognitive Reserve Markers Between Childhood Cognition and Cognitive Aging: Evidence From the 1946 British Birth Cohort

BACKGROUND AND OBJECTIVES

As the population ages, differences in cognitive abilities become more evident. We investigated key genetic and life course influences on cognitive state at age 69 years, building on previous work using the longitudinal Medical Research Council National Survey of Health and Development (the British 1946 birth cohort).

METHODS

Multivariable regressions investigated the association between 4 factors: (1) childhood cognition at age 8 years; (2) a Cognitive Reserve Index (CRI) composed of 3 markers: (i) educational attainment by age 26 years, (ii) engagement in leisure activities at age 43 years, and (iii) occupation up to age 53 years; (3) reading ability assessed by the National Adult Reading Test (NART) at age 53 years; and (4) APOE genotype in relation to cognitive state measured at age 69 years with Addenbrooke's Cognitive Examination, third edition (ACE-III). We then investigated the modifying role of the CRI, NART, and APOE in the association between childhood cognition and the ACE-III.

RESULTS

The analytical sample comprised 1,184 participants. Higher scores in childhood cognition, CRI, and NART were associated with higher scores in the ACE-III. We found that the CRI and NART modified the association between childhood cognition and the ACE-III: for 30 additional points in the CRI or 20 additional points in the NART, the simple slope of childhood cognition decreased by approximately 0.10 points (CRI = 70: marginal effects (MEs) 0.22, 95% CI 0.12-0.32, p < 0.001 vs CRI = 100: MEs 0.12, 95% CI 0.06-0.17, p < 0.001; NART = 15: MEs 0.22, 95% CI 0.09-0.35, p = 0.001, vs NART = 35: MEs 0.11, 95% CI 0.05-0.17, p < 0.001). The association between childhood cognition and the ACE-III was nonsignificant at high levels of the CRI or NART. Furthermore, the e4 allele of the APOE gene was associated with lower scores in the ACE-III (β = -0.71, 95% CI -1.36 to -0.06, p = 0.03) but did not modify the association between childhood cognition and cognitive state in later life.

DISCUSSION

The CRI and NART are independent measures of cognitive reserve because both modify the association between childhood cognition and cognitive state.

Physical inactivity links depressive symptoms and cognitive functioning among individuals with Parkinson's disease

OBJECTIVE

Parkinson's disease (PD) is a neurodegenerative disorder caused by disruption of dopamine-producing cells. PD is associated with motor symptoms and nonmotor symptoms including depression and cognitive impairment. Past research suggests an association between depression and cognitive impairment in PD. Physical activity may have a therapeutic effect on both depression and cognitive impairment. The present study investigates if physical activity mediates the association between depressive symptoms and cognition in a longitudinal sample of individuals with PD.

METHOD

Participants include individuals newly diagnosed with PD (N = 487) enrolled in the Parkinson's Progression Marker Initiative (PPMI). Participants completed an array of neuropsychological tests over the course of 5 years, as well as questionnaires of depression and physical activity. Between-person and within-person effects of depression and cognition mediated through physical activity were analyzed using structural equation modeling.

RESULTS

A significant direct effect demonstrated depression was associated with worse global cognitive functioning. Furthermore, there was a significant indirect within-person effect, indicating that physical activity fully mediated the association between depression and cognition. Individuals who became more depressed over time became less physically active and subsequently experienced cognitive decline over the 5-year period.

CONCLUSIONS

Findings have implications for prognostic detection and/or the role of physical activity interventions to buffer effects of depression on cognitive impairment among individuals diagnosed with PD. Physical interventions may potentially be implemented among depressed persons to preserve cognitive functioning. Worsened depression early during PD may be a risk factor for inactivity and cognitive diminishment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Examining heterogeneity in depression symptoms and associations with cognition and everyday function in MCI

INTRODUCTION

Although there is some evidence that different symptoms of depression have differential effects on cognition in older adults, these relationships remain understudied in older adults with mild cognitive impairment (MCI).

METHOD

Older adults (>50 years old) were classified as having MCI by Alzheimer's Disease Research Centers (ADRCs). Exploratory factor analyses and factor mixture modeling were used to determine depression symptom classes. Classes were then compared across different domains of cognition (i.e., memory, attention, language, and executive function) and informant-rated everyday function.

RESULTS

Analyses revealed six, distinct symptom classes (i.e., somatic symptoms, severely depressed, anhedonic symptoms, cognitive symptoms, minimally depressed, and low life satisfaction symptoms). Classes significantly varied on all measures of cognition and everyday function. In particular, the anhedonic class often showed the most substantial decline (on par with the severely depressed class), while the low life satisfaction class often showed the least (on par with the minimally depressed class).

CONCLUSIONS

To our knowledge, this is the first study to examine the relationship between depression symptom profiles and cognitive and everyday function in those with MCI. Our findings show that depression symptoms greatly differ in their associations with cognitive and everyday function. It may be beneficial for clinicians to specifically note if patients with MCI are reporting anhedonic and somatic symptoms of depression specifically.

Physical activity and depressive symptoms among community-dwelling older adults in the COVID-19 pandemic era: A three-wave cross-lagged study

The aim of the study is to determine the trajectories of physical activity and depressive symptoms and their reciprocal relationship among community-dwelling older adults in the COVID-19 pandemic era. The study population consisted of a cohort of 511 participants aged 60 years and over, who were recruited from eight community health centers in Ya'an, China. The Physical Activity Scale for the Elderly and the Patient Health Questionnaire were respectively used to measure physical activity and depressive symptoms at three time points: before the COVID-19 outbreak (T₀), during the outbreak period (T₁), and after the subsidence of COVID-19 (T₂). The results revealed that physical activity and depressive symptoms fluctuated substantially across T₀, T₁, and T₂. In addition, more severe depressive symptoms at T₀ and T₁ were significantly associated with lower levels of physical activity at T₁ and T₂, but the obverse direction of physical activity being associated with subsequent depressive symptoms was not observed in the current study. These findings highlight the importance of supporting old people to remain physically active and combat mental distress early in a pandemic, and prevention and management of depressive symptoms may also be beneficial to promote physical activity.

Depressive Symptoms, Leisure Activity Engagement, and Global Cognition in Non-Hispanic Black and White Older Adults

OBJECTIVES

Prior research indicates that depressive symptoms disproportionately affect cognition in non-Hispanic Blacks relative to non-Hispanic Whites. Depressive symptoms have been linked to worse global cognition in older adulthood through lower leisure activity engagement, but less is known regarding the distinct types of activities that drive these associations and whether associations involving depressive symptoms, leisure activities, and cognition differ across racial groups.

METHODS

This cross-sectional study used data from the Michigan Cognitive Aging Project (n = 453, 52.80% Black, Mage = 63.60 years). Principal components analysis identified 6 subtypes of leisure activities (cognitive, creative, community, physical, children, and games). Mediation models examined whether distinct leisure activity subtypes mediated the association between depressive symptoms and performance on a comprehensive neuropsychological battery and whether race moderated these associations.

RESULTS

There were no racial differences in the level of depressive symptoms after adjusting for sociodemographic, socioeconomic, and health covariates. Only lower cognitive activity engagement mediated the negative association between depressive symptoms and global cognition. Multigroup models revealed that this indirect effect was only evident in Blacks, who showed a stronger negative association between depressive symptoms and cognitive activity engagement than Whites. After accounting for indirect effects, a direct effect of higher depressive symptoms on worse cognition remained and did not differ across racial groups.

DISCUSSION

Depressive symptoms may disproportionately affect cognition among Blacks through a greater negative impact on engagement in cognitively stimulating activities that have been shown to promote cognitive reserve. Additional research is necessary to identify other mechanisms linking depressive symptoms and cognition.

A Long-Term Enriched Environment Ameliorates the Accelerated Age-Related Memory Impairment Induced by Gestational Administration of Lipopolysaccharide: Role of Plastic Mitochondrial Quality Control

Studies have shown that gestational inflammation accelerates age-related memory impairment in mother mice. An enriched environment (EE) can improve age-related memory impairment, whereas mitochondrial dysfunction has been implicated in the pathogenesis of brain aging. However, it is unclear whether an EE can counteract the accelerated age-related memory impairment induced by gestational inflammation and whether this process is associated with the disruption of mitochondrial quality control (MQC) processes. In this study, CD-1 mice received daily intraperitoneal injections of lipopolysaccharide (LPS, 50 μg/kg) or normal saline (CON group) during gestational days 15–17 and were separated from their offspring at the end of normal lactation. The mothers that received LPS were divided into LPS group and LPS plus EE (LPS-E) treatment groups based on whether the mice were exposed to an EE until the end of the experiment. At 6 and 18 months of age, the Morris water maze test was used to evaluate spatial learning and memory abilities. Quantitative reverse transcription polymerase chain reaction and Western blot were used to measure the messenber RNA (mRNA) and protein levels of MQC-related genes in the hippocampus, respectively. The results showed that all the aged (18 months old) mice underwent a striking decline in spatial learning and memory performances and decreased mRNA/protein levels related to mitochondrial dynamics (Mfn1/Mfn2, OPA1, and Drp1), biogenesis (PGC-1α), and mitophagy (PINK1/parkin) in the hippocampi compared with the young (6 months old) mice. LPS treatment exacerbated the decline in age-related spatial learning and memory and enhanced the reduction in the mRNA and protein levels of MQC-related genes but increased the levels of PGC-1α in young mice. Exposure to an EE could alleviate the accelerated decline in age-related spatial learning and memory abilities and the accelerated changes in MQC-related mRNA or protein levels resulting from LPS treatment, especially in aged mice. In conclusion, long-term exposure to an EE can counteract the accelerated age-related spatial cognition impairment modulated by MQC in CD-1 mother mice that experience inflammation during pregnancy.

Psychological distress links perceived neighborhood characteristics to longitudinal trajectories of cognitive health in older adulthood

RATIONALE

Perceived neighborhood characteristics have been linked to cognitive health in older adulthood. The pathways through which neighborhood characteristics could influence cognition in older adulthood, however, have not been fully explored. Poorer quality neighborhoods may negatively influence cognition through feelings of psychological distress.

OBJECTIVE

To examine whether perceived neighborhood physical disorder and social cohesion were associated with change in episodic memory and semantic verbal fluency through anxiety and depressive symptoms.

METHODS

Using the Health and Retirement Study (HRS; n = 13,919), mediation models were conducted. Change in cognition (episodic memory and semantic verbal fluency) were modeled using latent growth curve models.

RESULTS

Higher physical disorder was associated with worse initial episodic memory and verbal fluency through greater anxiety symptoms. Higher social cohesion was associated with better initial episodic memory and verbal fluency through both lower anxiety and fewer depressive symptoms. Further, individuals with higher social. cohesion reported lower anxiety and in turn, showed a slower rate of verbal fluency decline. A direct effect of physical disorder on initial episodic memory remained, after accounting for indirect effects and covariates.

CONCLUSIONS

Overall, individuals who live in neighborhoods with high physical disorder and low social cohesion may experience greater psychological distress. Symptoms of anxiety and depression may, in turn, interfere with cognitive functioning. Neighborhood characteristics may be an important, targetable area for intervention to improve not only mental health outcomes, but cognitive health outcomes in older adulthood.